‘Tripledemic’ of Flu, RSV and Covid

By: Melody Rabor-Dizon

 

An overwhelming sense of threat and apprehension fill hospitals, doctor’s offices’ and urgent care centers as Respiratory Syncytial Virus or RSV is on the rise. RSV is a virus that affects the airway and lungs commonly targeting infants less than 2 years old. RSV season usually starts in October till March in the Midwest region of the country, however severity and volume of cases has come earlier than expected. An overflow of beds is becoming a problem in the hospital setting, pediatric ICU beds are running low per Lurie Children’s Hospital in Chicago and everyone is encouraged to take the flu shot and the COVID booster (to those who are eligible). As of current, there is no vaccine yet for RSV.

What we need to know about RSV:

Let’s inform ourselves, especially to our young mommies and daddies who have little ones at home.

1. Adults can catch the virus but it is the very young and the very old who are more at risk.

In older children and adults, respiratory syncytial virus may not have any symptoms or may resemble those of common cold, including cough, fever, congestion, and fatigue. The illness usually clears up on its own in less than a week. However, RSV can be severe in infants and young children. Signs and symptoms can progress to more complicated respiratory infections like pneumonia or bronchiolitis requiring hospitalization, especially those with underlying conditions that compromise lung function. These include premature infants, children less than two years old with heart or lung disease, those with neuromuscular disorders that cause difficulty swallowing or clearing secretions and children with compromised immune systems.

2. Signs and Symptoms of RSV: Symptoms mimic those of many other common childhood illnesses and can include:

• Fever

• Runny nose

• Cough

• Wheezing

• Earache

• Fussiness

• Low energy

• Decreased appetite

3. Spread of RSV / Prevention

Because there is no vaccine yet for respiratory syncytial virus the best prevention is to take precautions to prevent spread of the virus. RSV spreads from person to person through respiratory droplets. Someone with RSV is most contagious within the first few days of infection but may be able to spread the disease for as long as four weeks. The virus spreads through coughing, sneezing, or direct contact, such as touching an object with the virus and then touching the mouth, nose, or eyes. Therefore, you can help prevent RSV the same way you would prevent other contagious illnesses:

• Wash your hands frequently, especially after touching public surfaces like doorknobs.

• Limiting your child’s contact with people who may be sick, especially if your child is very young or especially at risk for getting sick.

• Frequently wash toys, pacifiers and other items that children tend to put in their mouths.

• Cover your mouth and nose when coughing or sneezing by directing your mouth and nose into your elbow/shirt sleeve, and teach your children to do the same (if they are old enough).

• Any exposure to tobacco products increase risk for infection and can develop severe symptoms.

• If your baby is at high risk of developing a serious illness from RSV (such as previous heart or lung disease), there is a medication that can be injected monthly to help prevent it. Talk to your pediatrician if you think your baby might benefit from this treatment.

4. Diagnosis Doctors do not have to positively diagnose respiratory syncytial virus to begin treating the symptoms. There are tests for RSV, but they usually are not necessary. A pediatrician can often diagnose RSV after hearing about a child’s symptoms, especially if there has been an outbreak in the area. The test for RSV only requires a sample of mucus from the nose. Rapid antigen testing is more accurate with children than adults. A chest x-ray can diagnose inflammation, and pulse oximetry monitors the oxygen levels in the blood.

5. Treatment Mode of treatment focus on comfort measures. Over-the-counter medications to reduce fever, and nasal drops or sprays can help alleviate congestion. Hydration is important, especially for young infants and children who can dehydrate quickly. If the infection is severe, the patient may need hospitalization. Interventions include IV fluids, supplemental oxygen, and mechanical ventilation. There are no antiviral medications for respiratory syncytial virus as of yet. A mild case of RSV can be treated at home the same way a bad cold would be treated.

• If the child has pain or a fever, give a pain and fever reducer such as children’s acetaminophen (such as Tylenol) or children’s ibuprofen (such as Advil).

• Ease congestion with a cool mist humidifier to thin secretions

• Give the child lots of fluids to prevent dehydration.

• Use a bulb syringe to clear mucus from the nose if the child is too young to use a tissue.

6. Seek Medical Care Do not wait too long to seek medical advice. Never second guess to call your pediatrician or 911 especially if child:

• Begins breathing fast, wheezing or has other difficulty breathing

• Has a cough that continues to get worse and worse

• Looks blue around the mouth or fingertips

• Has difficulty sucking and swallowing

• Develops any fever of more than 100.4° F at the age of 0–3 months, 101° F or greater at the age of 3 to 6 months, or 103° F at the age of 6 months or older

Cook County Health physicians came together recently to urge folks to get boosted for COVID and get their flu and pneumonia shots. Health officials say that 80% of people in suburban Cook County have gotten at least one shot of the COVID vaccine, but only 9% have received the latest bivalent booster shot.

Physicians are fighting the same uphill battle that people just don’t seem to be getting the shot, and they also worry a winter surge is upon us. “The weather is colder in much of the country, including certainly here in Chicago,” per Illinois Department of Public Health (IDPH). “Parties move indoors and multigenerational families are gathering for the holidays. “With hospitals now facing a triple threat of COVID, the flu, and RSV and emergency rooms already becoming full, doctors are pleading with people to get their flu and COVID booster shots, as RSV doesn’t have a vaccine.

“Given our limited capacity, we want to make sure all hands are on deck and making sure everybody gets every booster and vaccine that’s available to them, so that we can have those at availability, should the RSV rates continue to tick up,” Health experts claim. In addition, doctors are on the lookout to see if a new COVID-19 variant develops this winter, which has happened in the previous two winters of the epidemic.

I am so not looking forward to another round of virus after virus after virus. Let’s just do our job mga kababayans and help our community be well, stay well and keep well.

Your advocate in care, Melody Dizon, RN Excerpts from: CDC, IDPH, Lurie Children’s hospital